Table 3.
Clinical, paraclinical and therapeutic characteristics of cardiomyopathy cases observed with transthoracic ultrasonography at Cayenne General Hospital between 1 January 2009 and 1 June 2014
| Cardiomyopathies global | Morphological anomaly | Functional anomaly | ||||
| Hypertrophic | Dilated | Mixed | Non-classified | Non-classifiable | ||
| N=182, n (%) | N=27, n (%) | N=114, n (%) | N=27, n (%) | N=1, n (%) | N=13, n (%) | |
| Clinical characteristics at inclusion | ||||||
| Stage of chronic cardiac failure | 60 (33.0) | 5 (18.5) | 44 (38.6) | 10 (37.0) | 0 (0.0) | 1 (7.7) |
| Dyspnea according to NYHA score | ||||||
| Median (IQR) | 2 (1–4) | 2 (1–3) | 2 (1–4) | 3 (1–4) | 1 (1–1) | 2 (1–4) |
| Patients with score>2 n (%) | 85 (46.7) | 10 (37.0) | 56 (49.1) | 14 (51.9) | 0 (0.0) | 5 (38.5) |
| Acute clinical presentation* | 145 (79.7) | 21 (77.8) | 89 (78.1) | 22 (81.5) | 1 (100.0) | 12 (92.3) |
| Acute cardiacfailure | 118 (64.8) | 12 (44.4) | 81 (71.1) | 19 (70.4) | 0 (0.0) | 6 (46.2) |
| Rythm and/or conduction anomaly | 57 (31.3) | 6 (22.2) | 34 (29.8) | 8 (29.6) | 1 (100.0) | 8 (61.5) |
| Stroke | 5 (2.8) | 2 (7.4) | 2 (1.8) | 0 (0.0) | 0 (0.0) | 1 (7.7) |
| Chest pain | 5 (2.8) | 2 (7.4) | 3 (2.6) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Fainting or syncope | 5 (2.8) | 3 (11.1) | 0 (0.0) | 2 (7.4) | 0 (0.0) | 0 (0.0) |
| Hemorrage | 4 (2.2) | 0 (0.0) | 3 (2.6) | 1 (3.7) | 0 (0.0) | 0 (0.0) |
| Others† | 6 (3.3) | 2 (7.4) | 4 (3.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| History of complications of CMP * | 59 (32.4) | 6 (22.2) | 41 (36.0) | 9 (33.3) | 0 (0.0) | 3 (23.1) |
| Acute cardiac failure | 37 (20.3) | 3 (11.1) | 27 (23.7) | 7 (26.0) | 0 (0.0) | 0 (0.0) |
| Rythm and/or conduction anomaly | 31 (17.0) | 0 (0.0) | 23 (20.2) | 6 (22.2) | 0 (0.0) | 2 (15.4) |
| Stroke | 7 (3.9) | 1 (3.7) | 3 (2.6) | 2 (7.4) | 0 (0.0) | 1 (7.7) |
| Pace maker or internal defibrillator | 6 (3.3) | 0 (0.0) | 6 (5.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Chronic cardiac failure | 1 (0.5) | 1 (3.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Heart transplant | 1 (0.5) | 0 (0.0) | 1 (0.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Others‡ | 9 (4.9) | 1 (3.7) | 5 (4.4) | 2 (7.4) | 0 (0.0) | 1 (7.7) |
| Paraclinical characteristics at inclusion | ||||||
| Ejection fraction of left ventricule (in %)§ | ||||||
| Median (IQR) | 35 (26–43) | 55 (38–71) | 30 (22–37) | 42 [30-54] | Uncalculable | 40 (25–40) |
| Range | 10–80 | 27–80 | 10–70 | 18–63 | 50–50 | 22–66 |
| Ejection fraction <40% | 130 (73.5) | 7 (25.9) | 100 (87.7) | 13 (48.1) | 0 | 10 (77.0) |
| Ultrasonographic functional profile | ||||||
| Systolic cardiac failure | 123 (67.6) | 10 (37.0) | 89 (78.1) | 14 (51.9) | 0 (0.0) | 10 (77.0) |
| Diastolic cardiac failure | 6 (3.3) | 2 (7.4) | 0 (0.0) | 1 (3.7) | 0 (0.0) | 3 (23.0) |
| Systolo-diastolic cardiac failure | 5 (2.7) | 0 (0.0) | 3 (2.6) | 2 (7.4) | 0 (0.0) | 0 (0.0) |
| Normal | 48 (26.4) | 15 (55.6) | 22 (19.3) | 10 (37.0) | 1 (100.0) | 0 (0.0) |
| Therapeutic characteristics at inclusion | ||||||
| Ongoing treatment* | 91 (50.0) | 12 (44.4) | 61 (53.5) | 12 (44.4) | 0(0.0) | 6 (46.2) |
| Antihypertensive drugs (apart from diuretics and beta-blockers) | 76 (41.8) | 10 (37.0) | 50 (43.9) | 12 (44.4) | 0(0.0) | 4 (30.8) |
| Diuretics | 57 (31.3) | 6 (22.2) | 43 (37.7) | 6 (22.2) | 0(0.0) | 2 (15.4) |
| Beta-blockers | 42 (23.1) | 5 (18.5) | 29 (25.4) | 5 (18.5) | 0(0.0) | 3 (23.1) |
| Antiplatelet aggregants | 28 (15.4) | 5 (18.5) | 17 (14.9) | 4 (14.8) | 0(0.0) | 2 (15.4) |
| Anticoagulation | 14 (7.7) | 0 (0.0) | 11 (9.7) | 2 (7.4) | 0(0.0) | 1 (7.7) |
| Antiarrythmics | 13 (7.1) | 0 (0.0) | 11 (9.7) | 2 (7.4) | 0(0.0) | 0(0.0) |
| Intervention | 11 (6.0) | 0(0.0) | 9 (7.8) | 2 (8.0) | 0(0.0) | 0(0.0) |
| Rhythmological apparatus | 7 (3.9) | 0(0.0) | 7 (6.1) | 0(0.0) | 0(0.0) | 0(0.0) |
| Cardiac surgery | 2 (1.0) | 0(0.0) | 0(0.0) | 2 (7.4) | 0(0.0) | 0(0.0) |
| Cardioversion | 1 (0.5) | 0(0.0) | 1 (0.9) | 0(0.0) | 0(0.0) | 0(0.0) |
| Heart transplant | 1 (0.5) | 0(0.0) | 1 (0.9) | 0(0.0) | 0(0.0) | 0(0.0) |
The ’Mixed’ morphological group includes 23 patients presenting at the same time hypertrophic and dilated morphology, 3 patients presenting at the same time a dilated and unclassified morphologies and 1 presenting at the same time hypertrophic and unclassified morphologies.
The functional impairment is defined by a systolic and/or diastolic dysfunction, diagnosed during transthoracic ultrasonography, without associations with a morphological anomaly, hypertension or valvulopathy, or coronaropathy, or congenital malformation.
*A single patient can present one or more events.
†The category ’others’ regroups the following events: complication of heart transplant, undocumented palpitation episode, myopericarditis episodes, thromboembolic accident and acute coronary syndrome.
‡The category ‘others’ regroups events in relation with arteriovenous thromboembolic disease, intervention (surgery or radiofrequency) and the occurrence of other cardiac symptoms (loss of consciousness during effort and acute coronary syndrome).
§The method measuring the ejection fraction of the left ventricule was found for 157 of 200 patients. It was a measure using Simpson’s method (64.3%), Teicholz’s method (33.8%), visual (0.6%), apex four cavities (0.6%) and disc summation method mono four cavities (0.6%). Reported ejection fractions are reported globally, independently from the clinical presentation.
CMP, cardiomyopathies.